The medial calcaneal nerve (or nerves — usually 1-3 small branches) supplies the medial heel skin and is the sensory nerve for the weight-bearing surface of the heel. Its entrapment between the abductor hallucis and the calcaneus produces the medial heel numbness of medial calcaneal nerve compression. It is important in heel reconstruction to preserve sensation to the weight-bearing heel pad.
| Origin | Tibial nerve (or medial plantar nerve) just proximal to or within the tarsal tunnel |
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Medial calcaneal nerve entrapment produces numbness and burning of the medial heel at the weight-bearing surface — a specific finding on Semmes-Weinstein monofilament testing. It is assessed in diabetic neuropathy as a marker of early sensory loss. Heel fat pad flap surgery must preserve or reconstruct sensation to maintain the heel's mechanoreceptor function.
Medial heel burning and numbness from nerve compression at the abductor hallucis managed with orthotic offloading and nerve block.
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